UNDERWATER MEDICINE 2012 Brac Reef Beach Resort Cayman Brac, BWIJanuary 21-28, 2012
HOTEL AND DIVING PACKAGES: All rooms are pool view with a private balcony or terrace. There are a limited number of junior suites with upgraded amenities. Rooms have two double beds or a single king-sized bed, TV, hair dryer, free wifi and air conditioning. Each package includes: Room for seven nights, daily breakfast, lunch, and dinner, 3 drinks per day, taxes and gratuities, airport transfers, porters, maids, a welcome and farewell cocktail party and a T-shirt. The diving option includes: six days of two one tank dives per day, diving gratuities, tanks, weights and weight belts. Please circle your selection from the following options (prices listed are per person):
Pool View Double Diver |
$ 1875 |
Pool View Single Diver |
$ 2290 |
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Pool View Double Non-Diver |
$ 1235 |
Pool View Single Non-Diver |
$ 1650 |
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Junior Suite Double Diver |
$ 2075 |
Junior Suite Single Diver |
$ 2690 |
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Junior Suite Double Non-Diver |
$ 1435 |
Junior Suite Single Non-Diver |
$ 2050 |
Name____________________________________ Name of person sharing room ____________________________ or-assign a Roomate
| PHONE: 610-896-8806 | FAX 610-896-2883 | EMAIL: sandy@scubamed.com | |
For credit card payment* please provide the following information:
| Credit Card | VISA | MASTERCARD | AMEX | (circle one) |
Name as it appears on the card ____________________________________________________________________
Card Number __________________________________________ Expiration date __________________________ Security code __________
Address to which credit card statement is mailed ______________________________________________________
____________________________________________________________________________________________
Signature ____________________________________________________________________________________
* Credit Card will be billed for balance on December 30, 2011
Cancellation Policy: All cancellations are subject to a $100.00 administrative fee. Due to hotel commitments, the $750.00 deposit will not be refunded for cancellations after November 20, 2011. ALL CANCELLATIONS AFTER DECEMBER 20, 2011 ARE NON-REFUNDABLE (INSURANCE IS STRONGLY RECOMMENDED).
PLEASE NOTE: Rates for single occupancy are higher. Every effort will be made to find a roommate for single registrants. If a roommate cannot be found, the single rate will apply. Because of advance reservations, full payment must be made by Nov 30, 2011. Please contact Sandy Bove for travel reservations from Grand Cayman to Cayman Brac. Group seats are being held on Cayman Air.
COURSE REGISTRATION
UNDERWATER MEDICINE 2012
JANUARY 21 - 28, 2012
| Return to: | Underwater Medicine Associates |
| P.O.BOX 481 | |
| Bryn Mawr, PA 19010 |
| PHONE: 610-896-8806 | FAX 610-896-2883 | EMAIL: sandy@scubamed.com | |
NAME_________________________________________________Degree__________
Practice Specialty _________________________________________
Name of Companion or Spouse _____________________________
Address___________________________________City __________________________
State ___________ Zip_______________Country________________
Telephone Home____________________ Office___________________ Cell ____________________ Fax_______________________
Email :______________________________________________________________________
* Course Fee and Hotel Deposit can be combined in one check.
| T-shirt size: | Small | Medium | Large | Extra Large | Extra Extra Large |
For credit card payment circle one: VISA MASTER CARD AMEX include the following information:
Name as it appears on the card ____________________________________________________________________
Card Number __________________________________ Expiration date __________________________ Security Code _____________
Address to which credit card statement is mailed ______________________________________________________
____________________________________________________________________________________________
Signature below also confirms credit card payment.
I understand that enrollment is limited, that my money will be refunded if the course is full, and that Underwater Medicine Associates reserves the right to cancel the program and return all course monies without further obligation if sufficient attendance is not secured by October 31, 2011. I understand that to dive, I must be a certified scuba diver with a recognized certification card. I am medically sound and physically fit for diving.
SIGNATURE _______________________________________________________Date _____________
SIGNATURE OF COMPANION(if diving) __________________________________Date _____________